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Medication Safety in the Hospital

Debra Gordon

Last updated: November 22, 2016 3:17 pm

Did you know that your hospital could kill you? A recent report found that between 210,000 and 400,000 deaths a year occur because of hospital-related errors, or, as the author calls it, “preventable harm.” That makes hospital-related deaths the third leading cause of death in the United States after heart disease and cancer. An earlier study found that patients suffered some kind of harm in one out of three hospital admissions, with some experiencing two or more.

Many of those errors are related to medications. The American Society of Health System Pharmacists identifies the following types of medication errors in hospitals:

  • Prescribing errors. This includes choosing the wrong drug, dose, form of drug, concentration, rate of administration or instructions.
  • Omission errors. This includes failing to give you the medication as ordered.
  • Wrong time error. This means you didn’t get the drug when you should have.
  • Unauthorized drug error. This means you received a drug that a physician or other authorized prescriber never approved.
  • Improper dose error. This means the dose you received is higher or lower than what you should have received, or you received more than one dose.
  • Wrong form of drug. For instance, instead of a pill, you received a patch; or instead of an infusion into your IV, the drug was injected directly into your arm.
  • Wrong preparation. This means the drug wasn’t formulated or prepared properly before administration. For instance, it wasn’t mixed right or it became contaminated during preparation.
  • Deteriorated drug error. You received a drug that had expired.
  • Monitoring error. No one reviewed the prescription to ensure that it was appropriate for your current condition, or assessed its impact on you.

While these errors are typically clinician based – the doctor, nurse, or pharmacist is responsible – there’s one more type that is your responsibility. That’s adherence. When you are prescribed a medication and it’s the right drug at the right dose at the right time, you need to take it or have a conversation with your doctor and/or nurse about why you don’t want to take it. It is always your choice as to whether you take it, but it’s important you understand the potential consequences of refusing it.

To reduce the risk of medication-related errors when you’re hospitalized, you need to advocate for yourself or have a friend or family member with you to advocate on your behalf. That means you:

  • Tell your doctor and nurse about any medications you take at home, and make sure you receive them in the hospital. Also tell your doctor and nurse about any herbal or nutritional supplements you take, even multivitamins.
  • Tell your doctor and nurse about any allergies every time you receive a drug.
  • Ask your doctor/nurse for a list of all prescribed medications and dosages that you’ll be receiving in the hospital.
  • Ask what the medication is every time the nurse comes in to give you a drug, switch out an IV bag, etc., why you’re receiving it, and what the dose is. Double-check it against your list.
  • Document every medication you’re given, including time and dosage.
  • Make sure the nurse verifies your identity by scanning your wristband and the bar code on the medication and/or confirms your name and birth date.

 

Although hospitals errors – particularly medication errors – are common, you do have the power to reduce your risk – and leave the hospital healthier than you entered.